Kylie Sanders, BS

Primary specialty

CounselorTaxonomy code 101Y00000X

License

CG61092325 Issued in WA

Practice address

6221 NE Fourth Plain Blvd Apt 130
Vancouver, WA 98661-7210

Phone

(360) 831-0908

NPI assigned

Aug 6, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sea Mar Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Vancouver, WA
  • NPI 1902414618
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1596672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596672000000",
    "number": "1699385393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6221 NE FOURTH PLAIN BLVD APT 130",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986617210",
            "telephone_number": "360-831-0908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6221 NE FOURTH PLAIN BLVD APT 130",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986617210",
            "telephone_number": "360-831-0908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "KYLIE",
        "credential": "BS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-06",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "CG61092325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CG61092325",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Micah Sanders-Massingale
• Amanda K Sanders
• Doris L Sanders
• Jordan Sanders
• Katelyn Louise Sanders
• Lauryn E Sanders, BA
• Viola Lucille Sanders, CDP
• Abigail Sanderson, LMT
• Akashdeep Singh Sandhu, M.D.
• Jasdeep Singh Sandhu, PA-C

• Counselor in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.